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30% of What?


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As someone with Rheumatoid Arthritis I do not believe that I will be able to take out top up insurance for this condition. I assume that it will be necessary for me to purchase my medication which would be a monthly requirement of three types of tablets plus a monthly blood test. I would be interested to hear details from anyone in a similar situation, I am aware of the 70%/30% details but need to know what 100% might be.
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What? is the price of the medication, doctors bills, lab tests etc, that are agreed by the Social Security and then they pay out a % on that.

These charges can be more than the Social Security figures and the mutualists do not always cover these extra costs.

If you do a search there is plenty on here about reimbursements for specific illnesses.

You are asking how long a piece of string is here, that is why it is impossible to be precise. Normal doctors visits are 20 and we get 70% back. Medication reimbursement varies from nothing to 70%.
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Rheumatoid Arthritis is one of the conditions or "affections" which can qualify for 100% cover by CPAM but it must be judged as "grave" by the treating doctor. He or she must then put the case up to CPAM for them to certify 100% cover. I would add here that if 100% cover is authorised it will only be for the arthritis and not for the rest of your healthcare needs.

If 100% cover is not granted you should receive 70% cover for your blood tests and 65% for your medication from CPAM. Should this be the case a top up insurance can be taken out to cover the difference even though it would be judged as a pre-existing condition. Top up health insurance in France is not the same as a pure private health insurance policy which would almost certainly exclude any claims relating to the arthritis.


Peter Owen
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Hi I have been living in France for two years now and came here suffering from Ankylosing Spondylitis and Crohns disease. This was declared to Swiss life before we took out the policy and like you I have to take regular medication and have blood tests. The policy from Swiss Life tops up the difference between what we pay out and what is paid back by the French state. There has so far been no problem with this at all. We don't hand over cash to pharmacies as we are in their computer system and have a document to prove it. You might want to put your situation to companies like Swiss Life, they have an English speaking agent in Bordeaux called Brian Mason and the agency is called Soficas tel 05 56 51 91 60 or email SOFICAS@wanadoo.fr. There seem to be lots of firms like this in France so it may pay to shop around although my impression is that for cover which will make up the difference, what ever it should be, is expensive but again these things are all relative! .....good luck.....John
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